Which child with asthma should the nurse see first?

Correct Answer: A

Rationale: In this scenario, the nurse should see the 12-month-old child with asthma first (Option A). This choice is based on the child's presenting symptoms of a mild cry, pallor, diminished breath sounds, and low oxygen saturation of 90% on room air. The 12-month-old is at higher risk due to their young age and inability to effectively communicate distress. Pallor and diminished breath sounds indicate a more severe asthma exacerbation requiring immediate attention. The oxygen saturation of 90% is below the normal range, indicating hypoxemia. Option B, the 5-year-old, is speaking in complete sentences, pink in color, and has a higher oxygen saturation of 95%, suggesting a less severe asthma exacerbation. Option C, the 9-year-old, although quiet, has a higher oxygen saturation of 94% and is wheezing bilaterally, indicating less severe distress compared to the 12-month-old. Option D, the 16-year-old, while in a tripod position and wheezing, has a higher oxygen saturation of 93% and is able to speak in short sentences, indicating a less urgent situation compared to the 12-month-old. In an educational context, it is crucial for nurses caring for pediatric patients with asthma to prioritize those at higher risk for respiratory compromise. Understanding the signs and symptoms of respiratory distress in children of different ages is essential for timely and effective intervention to prevent further deterioration.

Correct Answer: B

Rationale: In pediatric patients with congestive heart failure, the first-line treatment is typically diuretics (Option B). The rationale behind this is that diuretics help reduce fluid overload and relieve symptoms of congestion by increasing urine output. This helps decrease the workload on the heart and improve overall cardiac function. Antibiotics (Option A) are not the first-line treatment for congestive heart failure unless there is an underlying bacterial infection. Antivirals (Option C) are used to treat viral infections and are not indicated for heart failure. Steroids (Option D) may be used in certain cases of heart failure with inflammation, but they are not the primary treatment for relieving congestion and improving cardiac function. In an educational context, it is crucial for nursing students to understand the appropriate pharmacological interventions for pediatric patients with congestive heart failure. By learning the rationale behind using diuretics as the first-line treatment, students can provide safe and effective care to children with heart failure, optimize patient outcomes, and prevent complications associated with untreated congestion.

Correct Answer: D

Rationale: In Haemophilia B, there is a deficiency of clotting factor IX. The correct answer is option D. Clotting factor IX is also known as Christmas factor and is essential for the intrinsic pathway of blood coagulation. Option A, IV, is not the correct answer because factor IV is not typically associated with clotting factors related to hemophilia. Option B, VII, is incorrect because factor VII is not deficient in Haemophilia B but rather in another type of hemophilia known as Hemophilia A. Option C, VIII, is also incorrect because factor VIII deficiency is associated with Hemophilia A, not Haemophilia B. Educationally, understanding the specific clotting factor deficiencies in different types of hemophilia is crucial for nurses caring for pediatric patients with these conditions. Recognizing the correct clotting factor deficiency helps in appropriate treatment, monitoring for complications, and providing effective patient education regarding clotting factor replacement therapy and bleeding precautions. This knowledge is essential for delivering safe and effective care to pediatric patients with hemophilia.

Correct Answer: A

Rationale: Rationale: Laryngotracheobronchitis, commonly known as croup, is a viral respiratory infection that affects the larynx, trachea, and bronchi in children. The appropriate treatments for croup focus on managing airway inflammation and symptoms. In this context, the correct answer, option A, broad-spectrum antibiotics, is not typically indicated for croup because it is primarily caused by viruses, not bacteria. Antibiotics are not effective against viral infections like croup. Option B, corticosteroids, are appropriate in the treatment of croup as they help reduce airway inflammation, swelling, and improve breathing. Corticosteroids are considered a mainstay in managing moderate to severe croup cases. Option C, inhaled racemic epinephrine, is used in severe croup cases to reduce airway swelling and can provide rapid relief of symptoms. It is indicated for cases where there is significant respiratory distress. Option D, humidified oxygen, is also an appropriate treatment for croup to ensure adequate oxygenation. Humidified oxygen can help soothe the airway and improve breathing in children with croup. Educational Context: Understanding the appropriate treatments for pediatric respiratory conditions like croup is crucial for nurses caring for children with these conditions. It is important to differentiate between viral and bacterial infections to provide targeted and effective treatment. By knowing the right interventions, nurses can help manage symptoms, improve outcomes, and provide safe and evidence-based care to pediatric patients with respiratory illnesses.

Correct Answer: C

Rationale: The correct answer is C) It can provide early detection of certain congenital diseases. The APGAR scoring system is a quick assessment tool used to evaluate a newborn's overall condition immediately after birth. It focuses on five areas: Appearance, Pulse, Grimace, Activity, and Respiration. The purpose of the APGAR score is to assess the newborn's ability to adapt to extra-uterine life, not to detect congenital diseases. Option A is incorrect because APGAR scoring was indeed formulated by Virginia Apgar, a pioneering American obstetrical anesthesiologist. Option B is incorrect as it accurately reflects the main purpose of APGAR scoring, which is to evaluate the newborn's transition to the new environment. Option D is also incorrect as the APGAR score is typically done at 1 minute and 5 minutes after birth to assess the newborn's condition and response to initial interventions. Understanding the significance of the APGAR scoring system is crucial for nurses and healthcare professionals working in neonatal care. It helps in quickly identifying newborns who may need immediate medical attention and interventions to ensure a smooth transition to extra-uterine life. By knowing the correct purpose and timing of APGAR scoring, healthcare providers can provide timely and appropriate care to newborns, ultimately improving their outcomes.